Falling neonatal autopsy rates: neonatologists, pathologists, and relatives need to boost neonatal pathology.(Editorial)

The provision of perinatal and paediatric pathology services is a sign of an enlightened society. It symbolises the care that society attaches to the wellbeing of its young by trying to find out what makes each pregnancy and infancy go well or badly. Yet in their audit of neonatal autopsies in a tertiary referral centre published in this week's BMJ, Brodlie and colleagues found a general fall in autopsy rates over the past decade (p 761). (1) This occurred despite a senior clinician always asking relatives for permission for autopsies and the availability of a dedicated paediatric and perinatal autopsy service. What are we as clinicians and as the lay public to make of this?

Geographical differences may exist in requests for neonatal autopsies. Directors of British neonatal units may have reservations about requesting an autopsy in some cases, (2) but Australian neonatologists do not seem to share these. (3) Nurses' attitudes may differ from doctors'. (3) Grief counsellors, nurses, or social workers who may be in contact with parents can unconsciously send …